Friday, March 3, 2017

Cardiologist, Neurologist, And Others Charged In $50 Million Health Care Fraud Scheme, And Civil Suit Filed Against Clinic And Participants In The Fraud

Defendants Provided False Patient Medical Information and Used the Identities of Doctors Who Did Not Work at the Clinic to Submit More Than $50 Million in Fraudulent Health Care Claims

Preet Bharara, the United States Attorney for the Southern District of New York, William F. Sweeney Jr., the Assistant Director-in-Charge of the New York Field Office of the Federal Bureau of Investigation (“FBI”), Scott J. Lampert, Special Agent-in-Charge of the New York Regional Office of the United States Department of Health and Human Services Office of the Inspector General (“HHS-OIG”), and James P. O’Neill, the Commissioner of the New York City Police Department (“NYPD”), announced today criminal and civil actions relating to a 12-year scheme to defraud Medicaid, Medicare, and other private health insurance companies out of more than $50 million. Today’s actions include the unsealing of an Indictment charging ASIM HAMEEDI, FAWAD HAMEEDI, MICHELLE LANDOY, DESIREE SCOTT, EMAD SOLIMAN, and ARIF HAMEEDI with, among other things, health care fraud, identity theft, and making false statements, and the filing of a civil fraud lawsuit against CITY MEDICAL ASSOCIATES, P.C., and ASIM HAMEEDI, among others, seeking treble damages and civil penalties under the False Claims Act for the fraudulent claims for reimbursement submitted by CITY MEDICAL ASSOCIATES to Medicare and Medicaid between 2003 and November 2015.

ASIM HAMEEDI was arrested this morning in Manhattan. FAWAD HAMEEDI was arrested this morning on Long Island. LANDOY and SCOTT were each arrested this morning in Queens, New York. SOLIMAN was arrested this morning in Westchester County. ARIF HAMEEDI is outside the United States and has not yet been arrested. All of the defendants in custody will be presented later today in Manhattan federal court before Magistrate Judge Sarah Netburn.

Manhattan U.S. Attorney Preet Bharara said: “As alleged, these defendants that included a cardiologist and neurologist ran a medical practice that for years bilked public health care programs and private insurance companies of more than $50 million. Thanks to the hard work of federal and state investigators, this fraud has been revealed and the alleged perpetrators forced to face the consequences of their actions.”

FBI Assistant Director-in-Charge William F. Sweeney Jr. stated: “Public health insurance programs, like Medicare and Medicaid, are not a personal pocketbook for criminals seeking to exploit a program designed to help those who need these programs the most. As alleged, the six defendants carried out a massive health care fraud scheme against these programs and private insurance companies for over twelve years and submitted more than $50 million in fraudulent claims. The FBI is committed to working with our law enforcement partners to bring to justice those who defraud taxpayer funded programs.”

HHS-OIG Special Agent-in-Charge Scott J. Lampert said: “Health care fraud schemes like the one alleged here loot government health programs, compromise patient well-being, and undermine the public’s trust in the health profession. You can bet our agents will continue to thoroughly investigate such allegations and hold fraudsters accountable for their crimes.”

NYPD Commissioner James P. O’Neill said: “As alleged, this investigation revealed numerous calculated actions that occurred for more than a decade which resulted in more than $50 million in fraudulent claims. I commend the NYPD investigators and FBI agents who uncovered these criminal activities and whose efforts resulted in a thorough investigation and arrests related to this ill-fated scheme.”

According to the allegations in the Indictment and the Civil Complaint:[1]

ASIM HAMEEDI, a board-certified interventional cardiologist who was the president and owner of City Medical Associates, a cardiology and neurology clinic based in Bayside, New York (“CMA””), together with others employed by CMA, conducted a massive health care fraud scheme spanning 12 years and involving more than $50 million in fraudulent claims. ASIM HAMEEDI conducted this scheme with others employed at or associated with CMA, including ASIM HAMEEDI’s nephew, FAWAD HAMEEDI, ASIM HAMEEDI’s brother, ARIF HAMEEDI, MICHELLE LANDOY, and DESIREE SCOTT, who were also employees of CMA, and EMAD SOLIMAN, a board-certified neurologist with his own practice in Westchester, New York.

The multi-faceted scheme included, among other things: (1) making false representations to insurance providers, including providers paid through Medicaid and Medicare, about the medical condition of patients in order to obtain preauthorization for medical tests and procedures; (2) submitting false claims to insurance providers for tests and procedures that were not performed and/or medically unnecessary, as well as for drug items not used or provided; (3) paying exorbitant kickbacks to local primary care medical offices in exchange for lucrative referrals from these offices; (4) and accessing, without authorization, electronic health records of patients at a particular hospital based on Long Island, New York (“Hospital-1”), in violation of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) in order to identify patients to be recruited to CMA.

In furtherance of the scheme, and to hide from the insurance providers the huge volume of claims, including fraudulent claims, being submitted by CMA, ASIM HAMEEDI, FAWAD HAMEEDI, ARIF HAMEEDI, MICHELLE LANDOY, and DESIREE SCOTT submitted claims to the insurance providers falsely representing that medical tests had been ordered or performed by doctors who did not work at CMA and who had not ordered or performed the tests. These doctors included EMAD SOLIMAN, who knowingly participated in the scheme to allow CMA to submit false claims to the insurance providers in his name, as well as two other doctors who did not know that their identities were being used to further the fraud (“Doctor-1” and “Doctor-2”).

In addition, ASIM HAMEEDI and FAWAD HAMEEDI, with the assistance of ARIF HAMEEDI, used various unlawful means to obtain and maintain a high volume of patients for use in the fraudulent scheme, including, among other things, paying exorbitant kickbacks to local primary care offices and practitioners in exchange for referrals of patients by those offices and practitioners to CMA. Moreover, ASIM HAMEEDI and FAWAD HAMEEDI repeatedly, and without authorization, accessed information in electronic health records of patients of Hospital-1 to identify and recruit patients to the practice of ASIM HAMEEDI and CMA.

The charges against the defendants alleged in the Indictment, and the maximum penalties for those charges, are set forth in a chart below. Also set forth below is a chart with the defendants’ names, ages, and residences.

The Civil Complaint joins a civil fraud lawsuit previously filed under seal by a whistleblower under the False Claims Act. The civil case is pending before Judge Paul G. Gardephe.

Mr. Bharara praised the outstanding investigative work of the FBI, HHS-OIG, the NYPD, and the New York State Department of Financial Services.

The criminal case is being handled by the Complex Frauds and Cybercrime Unit, and Assistant U.S. Attorney Elisha J. Kobre is in charge of the prosecution. The civil case is being handled by Assistant U.S. Attorney Jacob M. Bergman of the Office’s Civil Frauds Unit.

[1] As the introductory phrase signifies, the entirety of the text of the Indictment and Civil Complaint and the descriptions of the Indictment and Civil Complaint set forth below constitute only allegations, and every fact described should be treated as an allegation.